To think this budget will finish us off

[BurnoutGP]

I am a GP Partner of over 20 years. I am now senior partner for the last few years. We have seen year on year below inflation funding increase. With an explosion in demand and massive shift of work from secondary care. We have issues wirh recruitment.
Our partner income is shrinking year on year. We are now always overdrawn and this gets worse every month.
We just cannot soak up the MLW and NI without adequate resource uplift.
I think we will be done. I'm so very tired of the constant battle and the demand and anger while working "part time" 60hr weeks.
We will have to hand back our contract. And we wont be the only one. That will leave one surviving practice in my area.
I'm done.

I’m so sorry to hear that op. You have my every sympathy. It’s been a very tough day in a long line of tough years.

I’m in a very similar boat. Small ‘professional’ services business. Very deprived area
, with high unemployment and the jobs that are available are low skilled.

I used to take significant pleasure in offer a large amount of professional time offering free services to those in need / charities. With the cost of living crises and significant increases in minimum wage over the last 4 years I’ve had to drastically reduce my charity work to keep the business afloat. Probably 8 hours a week reduced to 8 hours a month.

Disappointing but I still felt able to do my bit by offering jobs to young people and upskilling them. Giving them a ‘trade’ effectively and opportunities to develop professional careers.

Today’s announcement means that the last of the charity work will have to go. I will maintain the gap for those staff paid more than the living wage but at least one junior member of staff will be made redundant. This is the only way I can raise the money. There will be no hiring of young people for the foreseeable future.

To be honest my instinct is to shut up shop and obtain work as employee myself. I’d certainly be personally better off but feel awful about my staff and the jobs they would loose and the fact that they would find it almost impossible to find similar work locally. God knows how long I will be able to hold this position for.

Simply soul destroying.

Damage already done

Some of us can't. Literally. We cannot now afford to keep employing our staff at the hours they are currently doing.

Because it's not just the rise in minimum wage. It's also the rise in employer's National Insurance contribution.

Sure, but I supposed there’d be some sort of public sector carve out. Which a pp has said there is, in fact, though apparently not across the board.

It's usually only the very new/young new starters with minimal experience. It's the wage differential as we either need to give them a pay rise or lose them. But it's the NI that will be the killer.
Out of interest how much do you think a GP receptionist earns??

Absolutely, Labour wanted to do that back in the 40's when they formed the NHS, first they took over hospitals, then asylums a few years later, but the BMA resisted GPs becoming part of the NHS as they were used to getting paid by patients and wanted to keep the practice model.

But of course it doesn't work well with only one customer, the NHS, nor is it efficient that way. Vertical integration is the way forward for the NHS and that means taking over the GPs practices.

That's how I feel. I'm so tired of it. Of trying to keep the service going. Ready to hand the practice back and do something much less stressful.

How many employees do you have in your pub on over £5k a year? Employment allowance is going up from £5k to £10.5k so should cover most of the no rise for a small business, unless you are a very large pub with a lot of full time staff

The changes don't take effect until April do they?

Looks that way https://www.timeshighereducation.com/news/universities-hit-employer-national-insurance-hike-confirmed#:~:text=The%20threshold%20at%20which%20employers,in%20further%20cuts%20and%20redundancies.

Re the employer NI. I know the government said they wouldn't raise income tax but I think a small increase might be better than the employer NI increase? With the caveat that the extra income tax raised is definitely used to fund the essential public services needed - NHS including GP practices, social services, more council housing asap, supportive benefits system etc. These services are vital both for individuals in need and for the economy (access to timely and effective help reduces the amount of help needed and the period of time help is needed).

I agree about NMW. Lots of people use these type of jobs as second wages so it's more complicated than giving a salaried person a rise.
I used to work in Tesco which had many perks that are obviously tax and NI free. There was free food, staff discount, anytime free parking, flexible shifts/hours, personal days etc etc etc). It compensated the old £11 wage. Then it went up to £12 last year. An extra 20p and I can see some of the perks being cut.
I can see staff loosing out once they get taxed or reach student loan or universal credit thresholds too.

Small business owner, feel your pain. Between NI and min wage we're looking at +10% on staff bill - we don't actually pay nmw, we pay at least real living wage but they go up fairly well in line so it's a moot point. We can't shoulder that without increasing fees for our clients. Which may kill us off - and if we don't we'll just be pumping inflation back up.

Desperate

I'm so sorry to hear this op! And yes I agree. All our small surgeries sold out to big companies a few years ago and it's appalling 😔 it's all very well saying you should pay more but how can you without bankrupting yourself or selling out to a bigger company to the detriment of you customers ( In your case patients) I'm afraid that as I see it the government has shown it's true colours. I expect to see many more small companies go to the wall, if we get many more empty buildings in our high street our town is finished!

In nhs terms, I’d expect a gp receptionist to start at £26,530 (bottom of band 4) with more senior/extra responsibilities being on a band 5 - £29,970.

It will ultimately make conditions worse for staff too as employers will look to claw back money in other ways, like removing employee 'perks' whether that be removing complimentary refreshments in staff rooms, cutting back on xmas party budgets, fewer training courses etc. Bigger companies know things like this are a good way of retaining staff, small companies won't have that luxury.

Every supplier will be passing their increased costs on to us. And the only way we can pass those costs on is to - our customers. Who cannot pay them. Another pub goes get's shut down.

Yes. Believe it or not, businesses do actually look ahead.

I'm sorry to hear this too. It's one of the things that worried me when I heard that part of the budget.

Is it possible still that the NHS allocation will increase the amount given to general practice, enough to cover this? (if not more?) Will the spring NHS plan change things for GPs? I don't know when the next actual budget is.

I read somewhere also that it wasn't yet clear whether there was going to be some exceptions made for certain employers, and that they were waiting for details on how it might affect the NHS, so maybe there is still hope that it won't apply? I don't know if that's likely though.

I don't think the government realises how much of a crisis there is in general practice, and how worried patients are too, that so many GPs might leave.

Absolutely we need to lower the cost of living and need more social housing. We also need to stop the pressure on the UK economy by dealing with illegal immigration (basically the equivalent of the entire population of Stratford upon Avon has illegally come into the UK this year so far on the boats) it’s unsustainable

This budget does rather support the idea that Labour think all business owners (regardless of size or business activity) are fat cats sitting on enormous profits that they don't share with their employees or the government.

By now did you actually mean April, then? Which is more than 3 months away?

Let me try to find my tiny violin. Not.
As I said on a previous, bleating thread: if you can’t afford to pay your staff a decent, living wage then your business is not viable.
Two friends are GP partners. They’re far from poor.

The state should not be topping up the wages of full-time employees.

I hear you OP. My friend is in much the same situation as you as a GP partner. She has actually broken down to her husband and then to me tonight saying she can't keep it going as the increased costs are impossible and she is exhausted. If many are feeling this way, it's a disaster for healthcare.